Indefinite costs: When ongoing medication bills are decided: Shots

Suzanne and Jim Rybak, in the studio where their son Jameson encourages Suzanne to make beautiful beach bags, received $ 4,928 months after the decision.

By Gavin McIntyre / Kaiser Health News


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By Gavin McIntyre / Kaiser Health News


Suzanne and Jim Rybak, in the studio where their son Jameson encourages Suzanne to make beautiful beach bags, received $ 4,928 months after the decision.

By Gavin McIntyre / Kaiser Health News

From time to time, Suzanne Rybak and her husband Jim receive emails from their deceased son Jameson. Usually, it’s the email that needs a little thought, says Suzanne.

But on March 5, an envelope arrived for Jameson from McLeod Health.

Jim saw first. He turned to his wife and asked, “Did you take your blood medicine today?”

She saw showing him the envelope to rekindle the pain and anger their family had experienced since taking Jameson to McLeod Regional Medical Center in Florence, SC, two years ago.

As KHN previously reported, Jameson experienced withdrawal symptoms from quitting opioids. Suzanne feared for her son’s life and took him to McLeod’s emergency room on March 11, 2020.

There, they found a lack of addiction management and the potential for high health costs – two problems that plague many families affected by the opioid crisis and often lead to depression. time passed to save lives.

Jameson was not given medications to treat opioid use in the ER, nor was he given prescribers at other clinics, Suzanne said. The hospital wanted to put him in, but because he was not taken care of, Jameson feared a high bill. The hospital did not tell her its financial aid policy, Suzanne said. And he decided to leave.

Three months later Jameson, 30, died of an overdose in his nursery.

The months of the red

Over the next few months, the Rybaks received bills from McLeod Health that told Jameson. He owed $ 4,928, the bills said. Suzanne called and wrote to hospital officials until September 2020, when the bill was passed under the health system’s financial aid program.

That was the last they heard from McLeod Health until the new envelope arrived on March 5 – a week before the second anniversary of Jameson’s visit to the ER. That visit was what Suzanne called “the beginning of the end for my son.”

When the Rybaks opened the envelope, they found a standard bill for $ 4,928.

“I can’t explain my anger and frustration,” Suzanne said. “It’s always there, but when we get that word, we’re just heartbroken.”

There is no government data to show how many patients or their families receive pre -paid or forgiven medical bills, but credit card professionals say they often find out. Patients can get bills for claims paid for by their provider. A reminder may arrive after the patient submits the payment.

Unlike “surprise bills,” which often result from policy pieces when a provider does not go online, these are bills that are passed but are ongoing. They can take financial risks – patients end up paying for something they don’t actually owe, or bills are handed over to credit bureaus, prompting phone calls and bills. email. But more often than not it is a heart attack for most patients, who spend hours on the phone with customer service every time the bill goes up or goes back. Reviewing the conditions that led to the bill in the first place.

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For families like the Rybaks, it can feel like an inexhaustible supply. Suzanne Rybak declined to rejoin McLeod Health but told KHN about the new bill. Responding to questions from KHN, McLeod Health ruled the bill found by Rybaks was erroneous.

“However, our software program has revised this statement due to a technical problem,” spokesperson Jumana Swindler wrote. “We’re looking to make sure the other patients don’t have it and we’re sorry this family has been affected by the crime.”

A week after KHN’s questioning, Rybaks received a letter from the hospital explaining and apologizing for the offense.

Many bills are derived from human crime

Many financial issues like this are “melted into human crime,” said Michael Corbett, director of health care consulting for LBMC, a Tennessee -based organization that negotiates with health systems by dealing with issues such as billing and earning money. “There is no shortage of tools [to avoid this.] It’s a break in their practice. “

The employer may forget to sign the paid account, he said. Or the hospital could not agree on its bill with an outside organization and did not tell them that the bill was covered under the hospital’s financial aid program.

As hospitals and medical services merge under major health systems, the incidence of crime increases. Hospitals and clinics within the same system can have different backend applications, and within each hospital there are separate programs for fundraising and electronic health records, Corbett explains.

More and more health systems are able to handle the bills they are given. If responsibilities are not clearly defined, many employees may work unknowingly in the same hospital.

COVID-19 disease has increased the risk of malignancies, Corbett said. New financial professionals may have access to fast, virtual and remote training with little to no interaction with team members or supervision. Some financial institutions are unemployed, which leads to delays in patients receiving bills or notifications, he added.

To prevent wrongdoing, Corbett said, hospitals need to include full training and supervision of financial staff; implement the same procedures for everything from the collection of patient financial information to enrollment to the time they are billed; and, most importantly, to see if those procedures are followed.

For patients who find themselves in a situation like Rybak’s, Corbett said to call the hospital’s finance department and ask to speak with a senior leader in his financial circle. Unlike an accountant, this person can decide, Corbett said.

At the end of the conversation, ask for the explanation in writing, he added.

“You want and hope that those messages will be saved,” Corbett said, but that may not be the case. Or the notes are kept in a section of hospital files that have been deleted from a patient’s legal medical history, making it difficult for patients to access them later.

It’s a document editor

For Suzanne Rybak, it makes more sense to call McLeod Health to revise a bill. Instead, he added the statement to a journal, where he documented his financial problems with McLeod Health two years ago.

However, the intention was not immediately clear. The locksmith lives in his study, where Jameson remembers encouraging him to make beach bags and other things. He would say to use “fruit colors,” Suzanne recalled – her way of describing soft colors. Now she makes the lights in that room, paying attention to the scents that Jameson seems to like.

“I want hospitals to know that you’re not just sending this bill in a word,” Suzanne said. “There are some people sitting in that house, opening that letter and getting ideas. … It’s a disaster to carry all that stuff again.”

KHN (Kaiser Health News) is a government news agency that publishes in -depth journalism on health issues. It is an independent editing program of KFF (Kaiser Family Foundation).

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